Knee Pain and Problems
Brief anatomy of the knee:
The knee is a vulnerable joint that bears a great deal of stress from everyday activities
such as lifting and kneeling, and from high-impact activities such as jogging and
aerobics.
The knee is formed by the:
- tibia - shin bone or larger bone of the lower leg
- femur - thigh bone or upper leg bone
- patella - kneecap
Each bone end is covered with a layer of cartilage that absorbs shock and protects the
knee. Basically, the knee is two long leg bones held together by muscles, ligaments, and
tendons.
There are two groups of muscles involved in the knee. The quadriceps muscles, which are
located on the front of the thighs, straighten the legs. The hamstring muscles, which are
located on the back of the thighs, bend the leg at the knee.
Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic
bands of tissue that connect bone to bone. Some ligaments on the knee provide stability
and protection of the joints, while other ligaments limit forward and backward movement of
the tibia.
What are some common knee problems?
Many knee problems are a result of the aging process and continual wear and
stress on the knee joint (i.e., arthritis). Other knee problems are a result of an injury
or a sudden movement that strains the knee. Common knee problems include:
sprained or strained knee ligaments and/or muscles - caused by a blow
to the knee or a sudden twist of the knee. Symptoms often include pain, swelling, and
difficulty in walking.
torn cartilage - trauma can also tear the menisci (pads of connective
tissue that act as shock absorbers and also enhance stability). Cartilage tears can often
occur with sprains. Treatment may involve wearing a brace during an activity to protect
the knee form further injury. Surgery may be needed to repair the tear.
tendonitis - inflammation of the tendons that may result from overuse
of a tendon during certain activities such as running, jumping, or cycling. Tendonitis of
the patellar tendon is called jumper's knee.This often
occurs with sports such as basketball, where the force of hitting the ground after a jump
strains the tendon.
arthritis - osteoarthritis is the most common type of arthritis that
affects the knee. Osteoarthritis is a degenerative process where the cartilage in the
joint gradually wears away, and often affects middle-age and older people. Osteoarthritis
may be caused by excess stress on the joint such as repeated injury or being overweight.
Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed
and by destroying the knee cartilage. Rheumatoid arthritis often affects persons at an
earlier age than osteoarthritis.
How are knee problems diagnosed?
Knee problems are diagnosed in several ways, beginning with a medical history and physical
examination, followed by diagnostic tests, including:
- magnetic resonance imaging (MRI) uses energy from a powerful magnet to
create a series of cross-sectional images of a specific part of the knee. An MRI can often
determine damage or disease in a surrounding ligament or muscle.
- computerized axial tomography (CAT) scan or
computerized tomography (CT) scan produces cross-sectional images of the knee
tissues on a computer screen. These images show soft tissues more clearly than regular
x-rays.
- arthroscopy is a minimally-invasive diagnostic and treatment procedure
used for conditions of a joint. This procedure uses a small, lighted optic tube
(arthroscope) which is inserted into the joint through a small incision in the knee.
Images of the inside of the knee joint are projected onto a screen.
- bone scan (radionuclide scanning) uses a very small amount of
radioactive material, which is injected into the patient's bloodstream to be detected by a
scanner. This test shows blood flow to the bone and cell activity within the bone.
Treatment for knee problems:
Specific treatment will be determined by the physician(s) based on:
- patient’s age, overall health, and medical history
- extent of the disease, injury, or condition
- expectations for the course of the disease, injury, or condition
- patient’s tolerance for specific medications, procedures, or therapies
- patient’s (or family’s) opinion or preference
If initial treatment methods do not provide relief and x-rays show
destruction of the joint, the orthopaedist may recommend total joint replacement for the
knee.
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